Jessica R Swoboda, DDS,MSD

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

00010111 Issued in WA

Practice address

10050 NE 10TH St # STC
Bellevue, WA 98004-4121

Phone

(452) 455-2020

Fax

(425) 455-0310

NPI assigned

Jan 3, 2013

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MT

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• 406 Periodontics, PLLC

  • Periodontics
  • Bozeman, MT
  • NPI 1215655725
  NPD Authorized official
• Will S Fernyhough DDS PS

  • Periodontics
  • Bellevue, WA
  • NPI 1790900231
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1357171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1357171200000",
    "number": "1639416183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10050 NE 10TH ST # STC",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980044121",
            "telephone_number": "452-455-2020",
            "fax_number": "425-455-0310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10050 NE 10TH ST # STC",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980044121",
            "telephone_number": "452-455-2020",
            "fax_number": "425-455-0310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SWOBODA",
        "first_name": "JESSICA",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "DDS,MSD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-01-03",
        "last_updated": "2013-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "WA",
            "license": "00010111",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katie Swerland, ARNP
• Logan D. Swim, DPT
• Haily Michelle Swinger, FNP-BC
• Michael A Swistak, M.D.
• Virginia M Switzer, ARNP, RN
• Jessie Swofford
• Syeda Bakhtawar DMD PLLC
• Symmetry Physical Therapy PLLC
• Lara K Symonds, MA, LMFT
• Sympatcare Home Care

• Periodontics in Bellevue, WA
• Providers in Bellevue, WA by specialty
• Periodontics in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.